导乐分娩镇痛联合全程陪伴无痛分娩在高龄产妇中的应用效果

Application effect of Doula labor analgesia with full-time accompanying painless delivery in elderly parturients

目的探讨导乐分娩镇痛联合全程陪伴无痛分娩在高龄产妇中的应用效果。方法选取2017年12月~2018年10月广州市番禺区市桥医院及广东省妇幼保健院收治的316例高龄产妇作为研究对象,根据随机数字表法分为A与B组,每组各158例。A组未给予任何镇痛和陪伴的传统方式分娩,B组使用导乐分娩镇痛+全程陪伴无痛分娩。比较两组产程、镇痛效果、焦虑状态、产后出血量和分娩方式及新生儿情况。结果B组第一、二产程及总产程短于A组,差异有统计学意义(P<0.05),而两组第三产程比较,差异无统计学意义(P>0.05);B组分娩时视觉模拟量表(VAS)、焦虑自评量表(SAS)评分低于A组,产后出血量少于A组,差异均有统计学意义(P<0.05);B组自然分娩率高于A组,差异有统计学意义(P<0.05),两组新生儿窒息和新生儿Apgar评分比较,差异无统计学意义(P>0.05)。结论导乐分娩镇痛+全程陪伴无痛分娩能显著提高分娩镇痛效果,改善焦虑状态,减少产后出血量,缩短产程时间,提高自然分娩率。

Objective To discuss the application effect of Doula labor analgesia with full-time accompanying painless delivery in elderly parturients.Methods All 316 elderly women in Guangzhou Panyu Shiqiao Hospital and Guangdong Maternal and Child Health Hospital from December 2017 to October 2018 were selected as research objects,they were divided into group A and group B according to random number table method,158 cases in each group.Group A were given birth in a traditional way without any pain or companionship,group B were given Doula labor analgesia combine with full-time accompanying painless delivery.The time of labor,analgesic effect,anxiety state,postpartum hemorrhage,mode of delivery and neonatal status were compared between two groups.Results The time of the first and second labor and the total duration of labor in group B were shorter than those in group A,the differences were statistically significant(P<0.05),but the difference of the third delivery time of the two groups was not statistically significant(P>0.05).The visual analogue scale(VAS),self-rating anxiety scale(SAS)scores of group B were lower than those of group A,and postpartum hemorrhage was less than that of group A,the differences were statistically significant(P<0.05).The natural delivery rate of group B was higher than that of group A,the difference was statistically significant(P<0.05).The difference between the two groups in neonatal asphyxia and newborn Apgar′s score were not statistically significant(P>0.05).Conclusion Doula labor analgesia+full-time accompanying painless delivery can significantly improve the analgesic effect and anxiety state,reduce postpartum hemorrhage,shorten the labor time and improve the natural delivery rate.